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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(10): E1127-E1133
DOI: 10.1055/a-2409-3622
Original article

Clinical utility of a novel anchor pronged clip for mucosal defect closure after colorectal endoscopic submucosal dissection (with video)

Daijiro Shiomi 
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Mayo Tanabe 
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Naoyuki Uragami
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Akiko Toshimori
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Natsuki Kawamata
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Mikio Muraoka
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Rei Miyake
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Masayoshi Kure
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Hatsuka Nakamura
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Akinori Komagata
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Tomoaki Kakazu
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Yumi Kishi
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Takemasa Hayashi
2   Digestive Diseases Center, Showa University Northern Yokohama Hospital, Yokohama, Japan (Ringgold ID: RIN220878)
,
Takayoshi Ito
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Noboru Yokoyama
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
,
Haruhiro Inoue
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan (Ringgold ID: RIN378609)
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Abstract

Background and study aims The MANTIS Clip (Boston Scientific) is a novel anchor pronged clip designed to enhance tissue grasping and facilitate the closure of defects in the gastrointestinal tract. This study evaluates the feasibility and effectiveness of the MANTIS Clip for closing mucosal defects following colorectal endoscopic submucosal dissection (C-ESD).

Patients and methods A retrospective single-center study was conducted on patients who underwent C-ESD with MANTIS Clip closure from May 2023 to April 2024. The primary outcome measured was the complete closure success rate. Secondary outcomes included defect size, sustained closure rate, closure time, number of clips used, adverse events (AEs), and hospital stay duration.

Results The MANTIS Clip was used in 52 cases. The complete closure rate was 98.1% (51/52), with a sustained closure rate of 96.1% (49/51). The median closed defect size was 32 mm, with the largest being 62 mm. The median closure time was 8 minutes. Typically, one MANTIS Clip per defect was used, with only one lesion requiring two clips. The median number of additional clips used was seven. AEs included one case of bleeding (1.9%) and one case of post-ESD coagulation syndrome (1.9%), both managed without extending hospital stays. The median C-reactive protein level on the first day post-ESD was 0.35 mg/dL and the median hospital stay was 5 days.

Conclusions The MANTIS Clip is effective and practical for mucosal defect closure post-C-ESD, demonstrating high success and sustained closure rates with minimal complications. Future multicenter randomized trials are needed to further assess its efficacy and safety.

Keywords

Endoscopy Lower GI Tract - Colorectal cancer - Endoscopic resection (polypectomy, ESD, EMRc, ...)


Publication History

Received: 31 July 2024

Accepted after revision: 03 September 2024

Accepted Manuscript online:
09 September 2024

Article published online:
10 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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